Laparoscopic management of a cavitated noncommunicating rudimentary uterine horn of a unicornuate uterus: a case report

The role of laparoscopy in paediatric and adolescent gynaecology

Paediatric and adolescent gynaecology is a narrow field of medicine dealing with the diagnosis of and treatment of gynaecological diseases from the neonatal period to sexual maturity. The current trend in surgical gynaecology in the paediatric population is to minimise the degree of invasiveness of diagnostic and therapeutic procedures. This contributes to reducing the number of complications and the risk of infertility. Laparoscopic procedures are a challenge for paediatric surgeons and gynaecologists, not only because of the age of treated patients, and anatomical and physiological differences between different age groups but also because of the complexity of the pathology, the differentiation of cancer tumours, and the presence of congenital developmental defects.

Successful management of a rudimentary uterine horn ectopic pregnancy by combining methotrexate and surgery: A case report

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The prevalence of rudimentary uterine horn ectopic pregnancy is very low (1 in 76 000–150 000 pregnancies).

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Early diagnosis of a rudimentary horn pregnancy is the key to successful management.

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The medical treatment may be a successful adjuvant therapy to surgical removal in asymptomatic women.

Pregnancy in a non-communicating rudimentary uterine horn is rare but presents a significantly increased risk of maternal and foetal morbidity due to uterine rupture.

We describe a case of rudimentary horn pregnancy diagnosed in the first trimester in an asymptomatic and haemodynamically stable woman. Medical termination of the pregnancy was performed with systemic and intrasacular methotrexate. Laparoscopic uterine horn excision was performed three months after termination.

This case shows that early diagnosis of a rudimentary horn pregnancy is key to the successful management of this condition. Preoperative medical termination in an asymptomatic woman proved to be an effective and safe option that minimized surgical risks.

Laparoscopic excision of a rudimentary uterine horn in a child

Unicornuate uterus with a rudimentary horn is the rarest congenital anomaly of the female genital system. It can result in a variety of gynecologic and obstetric complications. This case report is an acute presentation of a cavitated, noncommunicating, rudimentary horn in a premenarcheal girl. Successful laparoscopic excision was performed. The full extent of the anomaly was diagnosed by a combination of operative findings and postoperative magnetic resonance imaging.